Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Two formerly competitive health data interoperability groups have agreed to work together to share data with each others’ members. CommonWell Health Alliance, which made waves when it included Cerner but not Epic in its membership, has agreed to share data with Carequality, of which Epic is a part. (Of course, Epic said that it chose not to participate in the former group, but let’s not get off track with inside baseball here!)

Anyway, CommonWell was founded in early 2013 by a group of six health IT vendors (Cerner, McKesson, Allscripts, athenahealth, Greenway Medical Technologies and RelayHealth.) Carequality, for its part, launched in January of this year, with Epic, eClinicalWorks, NextGen Healthcare and Surescripts on board.

Under the terms of the deal, the two will shake hands and play nicely together. The effort will seemingly be assisted by The Sequoia Project, the nonprofit parent under which Carequality operates.

The Sequoia Project brings plenty of experience to the table, as it operates eHealth Exchange, a national health information network. Its members include the AMA, Kaiser Permanente, CVS’s Minute Clinic, Walgreens and Surescripts, while CommonWell is largely vendor-focused.

As things stand, CommonWell runs a health data sharing network allowing for cross-vendor nationwide data exchange. Its services include patient ID management, record location and query/retrieve broker services which enable providers to locate multiple records for patient using a single query.

Carequality, for its part, offers a framework which supports interoperability between health data sharing network and service providers. Its members include payer networks, vendor networks, ACOs, personal health record and consumer services.

Going forward, CommonWell will allow its subscribers to share health information through directed queries with any Carequality participant. Meanwhile, Carequality will create a version of the CommonWell record locator service and make it available to any of its providers.

Once the record-sharing agreement is fully implemented, it should have wide ranging effects. According to The Sequoia Project, CommonWell and Carequality participants cut across more than 90% of the acute EHR market, and nearly 60% of the ambulatory EHR market. Over 15,000 hospitals clinics and other healthcare providers are actively using the Carequality framework or CommonWell network.

But as with any interoperability project, the devil will be in the details. While cross-group cooperation sounds good, my guess is that it will take quite a while for both groups to roll out production versions of their new data sharing technologies.

It’s hard for me to imagine any scenario in which the two won’t engage in some internecine sniping over how to get this done. After all, people have a psychological investment in their chosen interoperability approach – so I’d be astonished if the two teams don’t have, let’s say, heated discussions over how to resolve their technical differences. After all, it’s human factors like these which always seem to slow other worthy efforts.

Still, on the whole I’d say that if it works, this deal is good for health IT. More cooperation is definitely better than less.

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Back in March 0f 2013, six health IT vendors came together to announce the launch of the CommonWell Health Alliance. The group, which included Cerner, McKesson, Allscripts, athenahealth, Greenway Medical Technologies and RelayHealth, said they were forming the not-for-profit organization to foster national health data interoperability. (Being a cynical type, I immediately put it in a mental file tagged “The Group Epic Refused To Join,” but maybe that wasn’t fair since it looks like the other EHR vendors might have left Epic out on purpose.)

Looked at from some perspectives, the initiative has been a success. Over the past couple of years or so, CommonWell developed service specifications for interoperability and deployed a national network for health data sharing. The group has also attracted nearly three dozen HIT companies as members, with capabilities extending well beyond EMRs.

And according to recently-appointed executive director Jitin Asnaani, CommonWell is poised to have more than 5,000 provider sites using its services across the U.S. That will include more than 1,200 of Cerner’s provider sites. Also, Greenway Health and McKesson provider sites should be able to share health data with other CommonWell participants.

While all of this sounds promising, it’s not as though we’ve seen a great leap in interoperability for most providers. This is probably why new interoperability-focused initiatives have emerged. Just last week, five major HIT players announced that they would be the first to implement the Carequality Interoperability Framework.

The five vendors include, notably, Epic, along with athenahealth, eClinicalWorks, NextGen Healthcare and Surescripts. While the Carequality team might not be couching things this way, to me it seems likely that it intends to roll on past (if not over) the CommonWell effort.

Carequality is an initiative of The Sequoia Project, a DC-area non-profit. While it shares CommonWell’s general mission in fostering nationwide health information exchange, that’s where its similarities to CommonWell appear to end:

* Unlike CommonWell, which is almost entirely vendor-focused, Sequoia’s members also include the AMA, Kaiser Permanente, Minute Clinic, Walgreens and Surescripts.

* The Carequality Interoperability Framework includes not only technical specifications for achieving interoperability, but also legal and governance documents helping implementers set up data sharing in legally-appropriate ways between themselves and patients.

* The Framework is designed to allow providers, payers and other health organizations to integrate pre-existing connectivity efforts such as previously-implemented HIEs.

I don’t know whether the Carequality effort is complimentary to CommonWell or an attempt to eclipse it. It’s hard for me to tell whether the presence of a vendor on both membership lists (athenahealth) is an attempt to learn from both sides or a preparation for jumping ship. In other words, I’m not sure whether this is a “game changer,” as one health IT trade pub put it, or just more buzz around interoperability.

But if I were a betting woman, I’d stake hard, cold dollars that Carequality is destined to pick up the torch CommonWell lit. That being said, I do hope the two cooperate or even merge, as I’m sure the very smart people associated with these efforts can learn from each other. If they fight for mindshare, it’d be a major waste of time and talent.

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Health IT vendor Greenway Medical Technologies has agreed to be taken private by investment firm Vista Equity Partners for $644 million. The deal, which comes less than two years after the company went public, will roll up Greenway with Vitera Healthcare Solutions LLC, a privately-held EMR vendor which is owned by Vista Equity, Reuters reports.

Vista has agreed to pay $20.35 per Greenway share, about 19 percent more than the stock’s Tuesday close of $17.13 on the New York Stock Exchange. The price is more than the Greenway shares have seen through its existence as a public company. (According to Reuters, the shares saw a lifetime high of $19.44 in November.)

Greenway has said that stockholders owning about 50.9 percent of its shares have agreed to tender in their holdings and vote to push the deal through. All of Greenway’s directors and some of its executive officers have also agreed to do so, according to the Reuters report.

Vista must have seen tremendous value in hooking up Vitera with Greenway. After all, it’s willing to take on a financially wobbly company that lost $5.1 million in its 2013 fiscal year ending June 30 and pay a premium for it. Although Greenway has regularly commented that many of their revenue issues stem from their move to a monthly revenue model.

If nothing else, the deal bulks up both sides to a level that can only help during an era of EMR consolidation. According to the two companies, the combined entity will serve almost 13,000 medical organizations and 100,000 providers. The new health IT company will be marketed under the Greenway brand.

This transaction made me think about a recent post by my colleague John Lynn regarding the status of the EMR vendor marketplace. It’s his view that we’re past the “Golden Age of EHR Adoption” and that things will be tougher for vendors than ever before. Assuming he’s right — and his thesis is pretty hard to argue — we should see a lot more consolidation deals taking place in the near future.

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Wth EMR usability still shaky at best, it’s the developers that offer hands-on support that score highest when EMR usability gets rated, according to HIT researcher KLAS Enteprises, reportsModern Healthcare.

KLAS, which just completed its report “Ambulatory EMR Usability 2013, More Nurture than Nature,” spoke with 163 providers, specifically leaders of practices with more than 25 physicians. In nearly every case, the magazine said, providers’ greatest frustration was related to vendor relationships, not the software itself, KLAS told MH.

As part of its research, KLAS ranked nine vendors on how well “the typical physician” could efficiently and effectively perform six common EMR tasks/functions, including e-prescribing, medication reconciliation, physician documentation, problem lists, viewing patient information and supporting mobile devices.

Coming out on top was athenahealth, a Web-based vendor, which topped the list for getting providers to usability at first use, and second for having strong handholding relationships with customers.

Epic, which came up second in the overall composite ranking, was number one when respondents asked whether their vendor gave them good support in guiding them to usability. This was true despite the fact that Epic is also well known for usability complaints by physicians, and that Epic is built on configurable modules that lead to a steep learning curve.

GE Healthcare and Greenway Medical Technologies tied for third in the composite scoring.

McKesson had the most customers of any vendor in the survey reporting that the company was “not good” at helping users with its technology.

So, we have an interesting conclusion here: even if vendors turn out a difficult-to-use product, strong customer support can largely erase that disadvantage. Now, let’s see what happens when a big vendor turns out a product which is easy to use without a lot of handholding…

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Could it be that real interoperability between vendors is on the way? Five big EMR vendors — including three hospital-oriented giants and two doctor-focused players — have come together during HIMSS to announce plans to create common standards for health data sharing, reports Forbes.

Cerner, McKesson, Allscripts, athenahealth and Greenway Medical Technologies have joined to create a new non-profit called the CommonWell Health Alliance. (As most wags have noted, Epic is conspicuously absent from the mix.)

The partners haven’t disclosed a lot of detail as to how they plan to achieve interoperability amongst themselves, but the scheme seems to rely on creating a unique national ID. “Without a national ID and the ability to create true data that can be safely and securely sent between individuals, we are going to introduce new systemic risk back into the system,” Neal Patterson, founder, chairman and chief executive of Cerner told Forbes.

Patterson, public citizen that he is, said that the CommonWell Alliance isn’t a commercial effort but “an obligation.” That certainly sounds lovely, but with five hyper-competitive public companies forming up this effort, I’m skeptical to say the least. Besides, if it’s an obligation, why isn’t Epic so obligated?

John Halamka, Chief Information Officer of Beth Israel Deaconness Medical Center in Boston, has probably sniffed out more of partners’ true motivation. “They’re thinking of it as an enabler for new technologies,” Halamka suggests to Forbes, a move which can “raise the tide for all boats.”

Whether it raises any boats or not, creating interoperability links between these vendors certainly can’t hurt. After all, the more data sharing the better, particularly by major players with significant market share.

That being said, there’s still the matter of Epic being out of the picture, not to mention other major EMR players. How much of a practical difference the CommonWell Health Alliance can make is very much in question.

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As readers may know, Greenway Medical Technologies is a health IT vendor that sells an integrated EMR and practice management solution, as well as interoperability tools. The mid-sized vendor excited some criticism earlier this year when it decided to launch an IPO, as few vendors in its size class have done so to date. Naysayers argued that the moment wasn’t right for a company its size to compete with big health IT players for investors.

A few quarters later, Greenway’s stock is doing well, at about $18 per share, having started out at a $10 per share offering price. Analysts, myself included, aren’t surprised to see a well-positioned company in the ambulatory care space do well, but the $550 million firm has done better than expected.

Wall Street was taken by surprise by Greenway’s release of its 4th quarter results for fiscal 2012, in which the company reported revenue growth at 24 percent and raw profit margins at 60 percent (though overall profit stood at 16 percent after all other factors were considered).

What ‘s keeping the stock going seems to be nothing more than plain old fashioned dealmaking — and notably, larger deals that extend beyond lighting up one physician office at a time:

* Greenway cut a deal with HIT vendor Relay Health (a McKesson subsidiary) in which the two are offering HIE services.

* Walgreens chose Greenway’s EHR to wire up its pharmacies for immunizations and health testing.

* Greenway snagged an agreement with Michigan Health Connect, the state’s largest HIE, to provide its technology for practices and clinics using the vendor’s solution.

If you’re seeing a pattern here, you’re not alone. Greenway isn’t just flogging its EMR/PMS to hospitals and medical practices, it’s providing the “last mile” HIE connectivity which has most providers scratching their heads.

Without a doubt, Greenway has formidable competition on the HIE technology side — a story we don’t have space for here — but it seems to me that the combo of having a EMR, PMS and HIE technology to offer is a huge plus. Like the Wall Street folks, I’m interested to see if this combo keeps Greeway afloat. Things look pretty good at the moment.

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While there’s a number of large, publicly-traded EMR vendors out there — General Electric (NASDAQ: GE) and Cerner (NASDAQ: CERN) immediately come to mind — to date we haven’t seen many mid-sized or small companies kick off an initial public offering. But one medium-sized EMR/practice management vendor has broken the mold.

Today, Greenway Medical Technologies (NASDAQ: GWAY) took the plunge , pulling in $67 million to fund its operations. While the company had hoped to raise $100 million, its take is nothing to sneeze at. Health IT is a tricky investment, even for pros like yourselves, readers, and institutional investors in particular are a conservative bunch. The fact that they’re spending on a risky business means a lot.

Greenway, whose EMR is bundled with practice management software, had one heck of a ride today, with its stock climbing 30 percent during its first day of trading. The company sold 6.7 million shares at prices below its expected $11 to $13 range, diluting its intake somewhat, but the stock closed at a promising $13 per share.

The Carrollton, Ga.-based vendor has certainly done well in recent times. According to insider Wall Street blog Seeking Alpha, Greenway revenues shot up 55 percent, to $25.7 million, during the last quarter of operations. Operating margins went from negative to a positive 2 percent, which is at least a start. Its biggest cash generator during the quarter was licensing revenue, which climbed 49 percent.

What’s interesting about this IPO isn’t just the fact that it ended well for Greenway. After all, it did take in less than planned, and the Wall Street crowd justifiably wonders how it will fare in a mind-boggling competitive market. But it’s worth asking whether Greenway did better because it bundles both an EMR and practice management tools. Did the fact that Greenway wasn’t relying solely on EMR revenue contribute to its growth and financial success? It would be interesting to find out, as that might help predict whether the bundled model is especially popular with physicians.

As for those who’d seek to imitate Greenway, they may have a chance if they move soon. Seeking Alpha editors think HITECH will still pump enough money into the EMR market to make these companies a reasonable investment. And given how many doctors and hospitals are still struggling to put EMRs in place, I have to agree. In fact, given that an amazing number of hospitals and medical practices junk their first EMR, there may be a whole second wave of opportunity within three to five years.

All told, if the market’s response to a smallish IPO is any indication, you can expect a bunch of other EMR players to follow in its footsteps. I’m thinking it will be companies in the $100m to $200m range, as they’re small enough to need capital (much cheaper capital than banks offer these days!) and nimble enough to benefit from the cash influx. Stay tuned and in coming months, I’ll tell you which other EMR and HIT companies I’m betting will climb onto the launch pad.

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company’s social media strategies for Billian’s HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Earlier this Summer, I came across news that Greenway Medical Technologies – a developer of electronic health records (EHRs) and practice management and interoperability healthcare IT solutions located just outside of Atlanta – had taken to endorsing pro golfer Jason Dufner. It came as no surprise to me that a healthcare IT company was seeking to increase its profile among the general public. There has been a noticeable shift in increasing the public’s awareness of the impact of healthcare IT solutions on the patient care they will one day inevitably receive. It’s been a smart move on the part of providers and vendors alike to acquaint people with the technology that our government has spent so much time and energy on promoting. I was surprised, however, that Greenway Medical had chosen the celebrity endorsement route. (Golf wasn’t surprising, though. Greenway Medical’s CEO goes by the name of Tee Green.) How much increased visibility, not to mention interest, could a spokesperson bring while swinging a club on the fairway?

His first sponsorship outing at the British Open garnered little fanfare, as Dufner didn’t advance very far. Greenway Medical’s luck changed, however, as Dufner’s skill – and Tiger Woods’ ultimate absence – led him to place second at the PGA Championship last week. Held in Atlanta, the event offered a good excuse for my some of my colleagues at Billian’s HealthDATA, Porter Research and HITR.com to take a field trip to the Atlanta Athletic Club, where I suspect much of the local healthcare industry put in appearances over the tournament’s several days.

I’d have to agree with the Steve Campbell at EMRDailyNews.com, who offered congratulations to Dufner in a recent post “for a wonderful performance at the PGA and to whoever at Greenway made the decision to sponsor Mr. Dufner. The return on investment for that sponsorship just turned very positive.”

I’d also have to agree with one of the post’s commentators that “[r]egardless of his finish, Dufner and Greenway’s [credibility] rocketed this weekend with all of the primetime PGA coverage. Hours of it. And both Dufner and Greenway are classy and humble, in victory and defeat. Bottom line: EHR industry was another winner this weekend simply based on these associations.”

Perhaps Greg Fulton, Public and Media Relations Manager at Greenway Medical, puts it best: “Our main motivation was we felt it was time to continue to bring recognition to the entire health IT industry, now that initiatives like meaningful use are proving to be successful, and we have industry partners who have had good experiences being involved with the PGA TOUR.

“With Jason, we felt like we were partnering with a person first, a golfer second. He really does believe in the goals of innovative and sustainable care coordination that EHRs and healthcare IT can bring. He set up a foundation in his home state of Alabama following the tornado damage there to help people needing ongoing health services, for example.”

When I asked if Greenway Medical would consider entering into other celebrity endorsement deals sometime in the near future, Fulton explained the company’s celebrity strategy a bit further: “At HIMSS10 [in Atlanta], we did have Atlanta radio station deejay Melissa Carter, then of Q100, speak at a Greenway reception to her definite need for EHR data exchange and automated referrals, because she is a kidney transplant patient who needs that constant care coordination. And that’s what would make sense for what type, you ask, of celebrity or sports partnerships to undertake – ones that have a foundation in or can bring industry recognition and tell the story of the advancement of healthcare.”

Is it any wonder that Greenway Medical just announced its customers have secured more than $1 million in Meaningful Use incentives? How many more providers – many of whom are, it’s safe to say, avid golfers – are now aware of the company and will soon look into its products?

I’ll be interested to see what sort of healthcare IT celebrity endorsement pops up next, and where. NASCAR seems a likely candidate. I wonder if Danica Patrick has a coordinated care story to tell?